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FOtm ~CS Department Of the Treasury -Internal Rwenue Serviw
(Rev.Septemper1978) Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number w r~~ A ~ for oa~aw use b~ n.~o.,a..a on.~.
Jacksonville Y ~ ~1~
As provided by sections 6321, 6322. and 6323 of the Internal Revenue Code.
notice is given that taxes (including interest and penalties) have been assessed
against the following-named taxpayer. Demand for payment of this liability has 4 ~
been made, but it remains unpaid. Therefore,~there is a lien in favor of the United
States on all property and rights to property belonging to this taxpayer for the
amount of these taxes, and additional penalties. interest, and costs that may fj~EO e ~ ~ . aF~
~ accrue. sn. f:ur•tr ~ _
Arm.:' '
ttfF~ :y
Name of Taxpayer RECeE - _ ; ~ _ :aR
Ronald W. Hernandez ~ ~ ~ ~
Residence
1702 Elkhart Terra
Port St. Lucid, Florica 33450
Kind of Tax Tax Period Ended Dolts of Assessment IdentHyitq Number Miessws(aot
i (a) (b) (c) (tl) rd
1040 12 31-77 05-29-78 257-9o-~c9g z353.g7
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Place of Filing
Clerk of the Circuit Court
St. Lucie County Courthouse Tota~t = 2353•°7
Fort Pi~rce~ Florica 33450
This notice was prepared and signed at Fort Pierce, Flori~a • on
i
{ the 29th day of :bver.)ber ,tg 79
Signatu Title
C. :loran, Jr. ~ ~ 2is-: enue Officer
(NOte: Cerlrficats of olhcer aut lzed by law to fake acknow/etlpments b nol etientNl to the vaArr)lr d Motr~e aI
Fe0eral Tar; Llen O.C.M.2A~[p, Ip541,C.B. 125.j faMA